Active NPI
Laurie King, ATC, LAT
- Athletic Trainer
- Knightdale, NC
National Provider Identifier
1043640790
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 2389
- Practice address
- 162 Legacy Oaks Dr
Knightdale, NC 27545-6556 - Phone
- (919) 385-3666
- Fax
- (919) 660-8615
- NPI assigned
- Nov 16, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 2389 | NC | Primary |
Addresses
Primary practice location
162 Legacy Oaks Dr
Knightdale, NC 27545-6556
Mailing address
149 Beaver Dam Dr
Youngsville, NC 27596-9600
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2389 | NC | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1384560000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1640044800000",
"number": "1043640790",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "149 BEAVER DAM DR",
"city": "YOUNGSVILLE",
"state": "NC",
"postal_code": "275969600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "162 LEGACY OAKS DR",
"city": "KNIGHTDALE",
"state": "NC",
"postal_code": "275456556",
"telephone_number": "919-385-3666",
"fax_number": "919-660-8615"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KING",
"first_name": "LAURIE",
"credential": "ATC, LAT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-11-16",
"last_updated": "2021-12-21",
"certification_date": "2021-12-21",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "NC",
"license": "2389",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Knightdale, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.